Online Driver Application

Important – Please Note

Your application is not complete by simply submitting the application form from this web site. In addition to being in full understanding of the materials below, we require signed copies of the Request for Driver’s Safety Performance History Information from DOT Regulated Previous Employer(s) form.

Federal law requires that we have signed copies of these forms before we can process your application. To speed your application, these forms will be emailed to you to the email you have provided on the application. Fill them out and sign them, and fax them to our secure fax at 503-360-9607.

Submission of the Contractor’s Application is an agreement that you have read and are familiar with all materials in the links below.

Driver Requirements

Valid CDL
D.O.T. qualified long form physical
Two Calendar years recent verifiable over the road experience
No DUI in last 5 years
No suspension or revocation in last 5 years
No more than one chargeable accident in last two years
No more than four minor violations in last three years
No more than four different employers in past 2 years
Neat and clean appearance, and professional attitude
Twenty-four years of age
Commercial drivers license
Passport, Certificate of Naturalization, or Green Card

Personal information:

Position you are applying for: ContractorDriverContractor's Driver

First Name *

Middle Initial *

Last Name *

Date of Birth *

Social Security # *

Phone Number *

Your Email *

Do you have the legal right to work? * YesNo

Can you provide proof of age? * YesNo

Addresses you have resided in the last three (3) years: [current address is required]

Applicant Information

Have you worked for this company before? YesNo

If yes, when did you last work for us?

From:

To:

Reason for leaving?

Where?

Rate of Pay:

Position:

How did you hear about us?

Are you now employed? YesNo

If not, how long since your last employement?

Have you ever been bonded? YesNo

What bonding company?

Expected Pay?

Emergency Contact Information

Name:

Relationship:

Phone Number:

Name:

Relationship:

Phone Number:

Name:

Relationship:

Phone Number:

Education History:

Please select the highest grade completed: * Last School Attended: Last School City:

Employment History:

49 CFR 391.21(b)(10) and (b)(11)

Provide the requested information for ALL employers for the past three years. You must also list any employers for which you operated a commercial motor vehicle in the past 10 years.

Company 1:

Company Name

Supervisor's Name

Address

City

State

Zip

Phone Number

Position Held

From Date

To Date

Salary

Reason for Leaving

Were you subject to the FMCSRs* while employed here? YesNo

Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol? YesNo

Company 2 (Click here to add/remove another company):

Company Name

Supervisor's Name

Address

City

State

Zip

Phone Number

Position Held

From Date

To Date

Salary

Reason for Leaving

Were you subject to the FMCSRs* while employed here? YesNo

Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol? YesNo

Company 3 (Click here to add/remove another company):

Company Name

Supervisor's Name

Address

City

State

Zip

Phone Number

Position Held

From Date

To Date

Salary

Reason for Leaving

Were you subject to the FMCSRs* while employed here? YesNo

Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol? YesNo

Company 4 (Click here to add/remove another company):

Company Name

Supervisor's Name

Address

City

State

Zip

Phone Number

Position Held

From Date

To Date

Salary

Reason for Leaving

Were you subject to the FMCSRs* while employed here? YesNo

Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol? YesNo

Company 5 (Click here to add/remove another company):

Company Name

Supervisor's Name

Address

City

State

Zip

Phone Number

Position Held

From Date

To Date

Salary

Reason for Leaving

Were you subject to the FMCSRs* while employed here? YesNo

Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol? YesNo

Company 6 (Click here to add/remove another company):

Company Name

Supervisor's Name

Address

City

State

Zip

Phone Number

Position Held

From Date

To Date

Salary

Reason for Leaving

Were you subject to the FMCSRs* while employed here? YesNo

Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol? YesNo

Company 7 (Click here to add/remove another company):

Company Name

Supervisor's Name

Address

City

State

Zip

Phone Number

Position Held

From Date

To Date

Salary

Reason for Leaving

Were you subject to the FMCSRs* while employed here? YesNo

Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol? YesNo

Company 8 (Click here to add/remove another company):

Company Name

Supervisor's Name

Address

City

State

Zip

Phone Number

Position Held

From Date

To Date

Salary

Reason for Leaving

Were you subject to the FMCSRs* while employed here? YesNo

Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol? YesNo

The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone who operates a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) has a GVWR or weighs 10,001 pounds or more, (2) is designed or used to transport nine or more passengers, or (3) is of any size, used to transport hazardous materials in a quantity requiring placarding.

Driving Experience:

Straight TruckYesNo

Tractor and Semi-trailerYesNo

Tractor-two trailersYesNo

Tractor-three trailers (triples)YesNo

Motorcoach - School Bus (more than 8 passengers)YesNo

Motorcoach - School Bus (more than 15 passengers)YesNo

List states operated in, for the last five years
List special courses/training competed
List any Safe Driving Awards you hold and from whom
List any other trucking / transportation experience that you may have
List courses or training other than shown elsewhere in this application
List special equipment or technical materials you can work with

Accident Record:

For Last 3 Years - Including Private Vehicles 49 CFR 391.21(b)(7)

List all motor vehicle accidents in which you were involved during the 3 years preceding the date the Driver Qualification form was submitted, specifying the date and nature of each accident and any fatalities or Personal injuries it caused.

(Click here to add/remove another accident):

Traffic Convictions and Forfeitures:

For Last 3 Years - Including Private Vehicles 49 CFR §391.21(b)(8)

List all violations of motor vehicle laws or ordinances (other than violations involving only parking) of which you were convicted or forfeited bond or collateral during the 3 years preceding the date the Driver Qualification From was submitted.

(Click here to add/remove another traffic conviction):

License Information

49 CFR 391.21(b)(5)

List all unexpired commercial motor vehicle operator's licenses currently held. [current license is required]

License Suspensions, Revocations & Denials

49 CFR 391.21(b)(9)

Have you ever tested positive, or refused to test on any pre-employment drug or alcohol test administrated by an employer to which you applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years? YesNo If yes, can you provide proof that you have successfully completed the DOT return-to-duty requirements?

Have you ever been denied a license, permit or privilege to operate a motor vehicle? YesNo If yes, please explain:

Has any license, permit or privilege ever been suspended, revoked or canceled? YesNo If yes, please explain:

Is there any reason you might be unable to perform the functions of the job for which you have applied (as described in the job description)? YesNo If yes, please explain:

Have you ever been convicted of a felony? YesNo If yes, please explain:

Personal References

List three persons for references, other than family members, who have knowledge of your safety habits.

License Suspensions, Revocations & Denials

This certifies that this Driver Qualification Form was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. 49 CFR 391.21(b)(12).

I understand and agree that drug and alcohol testing will be performed in accordance with 49 CFR part 40 and any additional testing as required by the Company. Failure of any test, or a failure to submit to a test as requested, will be considered grounds for nonconsideration. I also understand and agree that failure of any test required by 49 CFR part 40 will be released to USIS (or any equivalent service as determined or utilized by the Company). I authorize the release of any controlled substance and/or alcohol test result in response to any inquiry regarding my work history with NV Transport Inc.

I understand that it is NV Transport Inc policy to maintain practices, which prevent discrimination against my person on the basis of race, creed, sex, religion, national origin, or any other protected classification.

I understand and agree that this Driver Qualification Form and other related documents will be retained for no longer than 30 days from the date of submission. At the conclusion of that time, if I have not been qualified by the Company and I still wish to be considered for qualification, it will be necessary for me to complete another Driver Qualification Form.

I understand and agree that any misrepresentation of information shall be considered an act of dishonesty and grounds for nonconsideration.

I understand and agree that this form does not obligate NV Transport Inc in any way. I understand that the information in this qualification form will be used for qualification purposes and that prior employers may be contacted for the purpose of investigation as required by 49 CFR 391.23.

I understand and agree that this form must be signed by me in order to commence with the qualification process with NV Transport Inc. Failure to sign this form will result in nonconsideration for qualification. Facsimile and electronic signatures shall be considered original signatures.

* I understand and acknowledge.

* You must agree to the terms before submitting the application.